5
The Changing Organization of Work

ABSTRACT. Globalization, technology, and other work-design factors and organizational design innovations present training needs for occupational safety and health professionals. Increasing reliance on computer technology, distributed work arrangements, increased pace of work, and increased diversity in the work environment create several challenges for occupational safety and health personnel. First, potential new hazards may emerge from the introduction of new technologies and through the performance of work in a more boundaryless or virtual organization. Second, businesses are becoming smaller and flatter (fewer levels of management) and are redefining the content of work and the nature of the employment relationship. They are pressured to compete for talent, innovate, provide exceptional service quality, and bring products and services to market fast at competitive prices. The implications of these business developments for workers include demand for new skills and continuous learning, expanded job scope, accelerated work pace, and changing workplaces. Workers face uncertainty in employment relationships, heightened interaction with both customers and other workers, and more involvement with information and communications technologies. Additionally, societal developments like the increasing numbers of single parents, dual-career households, and aged dependents challenge workers to manage multiple and competing interests in their work and home lives. These factors are major sources of time conflicts and carry the potential for dysfunction and distress in the U.S. workforce and at U.S. workplaces.

The committee concludes that occupational health and safety personnel must be knowledgeable about the effects of these changing structural and contextual work conditions on worker well-being and health. They must be competent in recognizing and accounting for the influenc-

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Safe Work in the 21st Century: Education and Training Needs for the Next Decade's Occupational Safety and Health Personnel . Washington, DC: The National Academies Press,
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5
The Changing Organization of Work
ABSTRACT. Globalization, technology, and other work-design factors and organizational design innovations present training needs for occupational safety and health professionals. Increasing reliance on computer technology, distributed work arrangements, increased pace of work, and increased diversity in the work environment create several challenges for occupational safety and health personnel. First, potential new hazards may emerge from the introduction of new technologies and through the performance of work in a more boundaryless or virtual organization. Second, businesses are becoming smaller and flatter (fewer levels of management) and are redefining the content of work and the nature of the employment relationship. They are pressured to compete for talent, innovate, provide exceptional service quality, and bring products and services to market fast at competitive prices. The implications of these business developments for workers include demand for new skills and continuous learning, expanded job scope, accelerated work pace, and changing workplaces. Workers face uncertainty in employment relationships, heightened interaction with both customers and other workers, and more involvement with information and communications technologies. Additionally, societal developments like the increasing numbers of single parents, dual-career households, and aged dependents challenge workers to manage multiple and competing interests in their work and home lives. These factors are major sources of time conflicts and carry the potential for dysfunction and distress in the U.S. workforce and at U.S. workplaces.
The committee concludes that occupational health and safety personnel must be knowledgeable about the effects of these changing structural and contextual work conditions on worker well-being and health. They must be competent in recognizing and accounting for the influenc-

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es of these work organization factors on physical, cognitive, and behavioral functioning, including stress-related conditions and their link to health, safety, and performance. Finally, occupational safety and health personnel must have a basic competence in prevention and organizational intervention strategies and be able to use work organization experts to address workplace stress and well-being issues.
Organization of work or work organization refers to management systems, supervisory practices, and production and service processes and their influence on the way in which work is performed (Sauter et al., 1999). Many if not all of these work organization factors have been shown to affect an organization’s culture (Schneider, 1987; Denison and Mishra, 1995) and attitudes toward training, problem-solving, labor relations, and its safety climate (Zohar, 1980; Hofmann and Stetzer, 1996). No data systems in the United States routinely collect information on work organization factors or the numbers and types of organizations and employees exposed to these factors. Nevertheless, it is clear that the past decade has witnessed major changes in both the organization and the nature of work, and it is anticipated that the magnitude and pace of change will continue in response to global competition, advances in technology, and accelerating accumulation of knowledge (Howard, 1995). This fluidity poses important challenges for occupational health and safety training, skills development, and worker safety. The following developments in work organization are most pronounced in large and midsize firms. However, their impacts are increasingly visible in smaller firms that are linked to larger employers in supply chains and service arrangements.
GLOBALIZATION OF TRADE
The accelerated evolution of global trade in the second half of the 20th century has created significant transformations in work organization. Developments in international trade have expanded access to markets, changed the landscape of competition, and increased the mobility of materials, production processes, and investment capital. The creation of a global economy has been facilitated by accords between nations on trade. Of these, the General Agreement on Tariffs and Trade (GATT) and the North American Free Trade Agreement (NAFTA) have been significant for the United States on a global and a regional basis, respectively. The regulatory regimes of GATT have reduced both traditional barriers to trade (e.g., tariffs and import quotas) and nontraditional barriers to trade (e.g., investment policy, local content requirements, and subsidies to domestic producers). More recently, GATT accords have focused on reducing constraints in the flow of both services and goods (Atkinson, 1998).

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NAFTA targets specific sectors for tariff reduction (e.g., automobiles, agricultural products, and energy) between the United States, Canada, and Mexico. It prohibits preferential treatment of local companies over ones based in foreign countries, and it limits member governments from influencing any investment or financial service related to trade. Supplemental accords related to NAFTA address environmental concerns, labor, and the subject of import surges (North American Free Trade Agreement, 1994).
Liberalization of trade through global and regional agreements has created a broader context for business decision making. It provides global businesses the opportunity to optimize business performance across the entire enterprise with fewer country-specific restrictions. It does this by enabling greater mobility of plants, equipment, supplies, subassemblies, finished goods, and investment. The impact of enhanced global trade on work organization can be substantial, ranging from wholesale translocation of processes or plants (e.g., maquilas in Mexico, Central America, and the Caribbean Basin) to competition-driven changes in performance and efficiency (e.g., automation, changed work processes, new skills, new employment arrangements, and new compensation systems).
Implications of Globalization for Training Needs of Occupational Safety and Health Personnel
Globalization has implications for the training of occupational health and safety personnel. Frumpkin (1998) presented seven issues. First, globalization and free-trade agreements may result in the relocation or displacement of employees by industries or firms. “Unemployment, fear of unemployment, migration, and the accompanying stress and social disruption have a profound impact on the health of workers and their families” (Frumpkin, 1998, p. 237). Second, countries differ in their health and safety standards, and third, they may differ in the degree to which they enforce health and safety regulations. Fourth, hazard communication requires multilingual information and training materials. The fifth issue that Frumpkin raised is the need for trained occupational health and safety personnel. He suggested that less affluent countries have a shortage of trained health and safety professionals. Therefore, organizations with multinational locations may need to provide trained professionals at least to train local personnel. The last two issues dealt with the need to have standardized surveillance data across country borders and the need to disseminate preventive practices and technologies, although not without attention to cultural differences among countries.

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WORK DESIGN
The basic arrangement by which work is accomplished has been changing rapidly as a result of global competition and technology. Incorporation of information technology into the workplace, distributed work arrangements, increased hours and pace of work, and diverse cultures in the workforce have all contributed to these changes
Information Technology in the Workplace
Information technology is transforming work along nearly every dimension (e.g., what, where, how, and by whom). Its speed of adoption has been faster than that of other major 20th century innovations. For example, the time that it has taken 30 percent of the U.S. population to become Internet users has been 7 years, whereas it was 17 years for television (U.S. Department of Labor, 1999a). In the United States, the proportion of homes with personal computers grew from 25 percent of all households in 1992 to 50 percent in 1998, and the proportion of all businesses with personal computers grew from 21 to 34 percent during the same 6-year period (John Fisher, International Business Machines Corporation, personal communication, September 3, 1999).
Accelerated use of information technology is enabling business to respond to opportunities and competition from a global marketplace. Figure 5-1 shows that U.S. business investments in computer hardware equipment, for example, have more than doubled since 1990, increasing from $38.9 billion to $95.1 billion in 1998 (U.S. Department of Commerce, 1999). U.S. software sales during the same period increased by a factor of almost three, growing from $50.8 billion to $140.9 billion in 1998 (Business Software Alliance, 1999). In addition, the complexity of information management needs in industry has created an information technology services business for outsourcing, consulting, systems integration, and product support with estimated revenues of $246 billion (John Fisher, International Business Machines Corporation, personal communication, September 3, 1999).
Commerce and work are undergoing major transformations related to this deployment of information technology. The changes are fundamental in nature and are redefining markets, business models, competitors, work methodologies, the concept of workplace, work values, and the life cycle of skills. For example, Internet-enabled “e-business” or “e-commerce” has affected marketing by allowing direct online customer ordering and customization. It has also reduced barriers to entry for new competitors and created competitors of formerly unrelated businesses (e.g., so-called aggregators, which source, bundle, and deliver products

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FIGURE 5-1 U.S. investment in computer equipment and software, 1990 to 1998.
SOURCES: Business Software Alliance (1999); U.S. Department of Commerce (1998).
produced by others). All industry sectors have been affected by the deployment of information technology because the processes of production, sales, and service are information intensive. Examination of computing technologies in the manufacturing and service sectors illustrates how business, work, and the workplace are being transformed by these technologies.
All core processes in manufacturing have been affected by information technology applications (Figure 5-2). Product design, for example, relies on data collected electronically from sources within and external to the enterprise to define customer requirements. It uses computer-aided designs and simulations to evaluate materials, parts, and assemblies, to test prototypes for performance, reliability, and safety, and to plan for meeting product end-of-life needs such as recycling or reuse. Database integration and analytical software permit assessment of design decisions on quality, cost, and maintenance requirements (National Research Council, 1995, 1999).
Production on the factory floor has expanded the use of computing technology beyond the electronic operation of equipment, sensors, and control systems (robots). Production processes are using information technology to perform real-time tracking of source materials, manage receiv-

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FIGURE 5-2 Information technology as a means of integrating various basic manufacturing activities. SOURCE: National Research Council (1995).
ing and parts flows, schedule production, perform quality control, manage inventories, and speed delivery to customers. Systems applications and networked computing provide an enhanced enterprisewide level of integration in manufacturing involving customers, suppliers, distributors, and other partners. This information-enabled integration has resulted in, for example, integrated product and process design, maximization of work in progress by complementing low inventories and a small labor force with high levels of equipment utilization, and transnational production facilities with networked operations (National Research Council, 1999).
The workforce and organizational effects of these transformations in manufacturing are diverse. At the enterprise level the impact of global competition is creating new business models that promote speed to market and increased flexibility to meet marketplace demands for customized products. These models create businesses composed of a core set of

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critical competencies that are closely linked to customers and that exhibit high levels of information-driven integration with suppliers, vendors, and other partners. Their link to other aspects of manufacturing, for example, product and process design or production, is varied and dynamic. Outcomes of such business arrangements have included joint venture formations, acquisitions and divestitures, workforce reductions (e.g., downsizing), and outsourcing of support services and production staffs. Competition and technology-enabled customer demands pressure manufacturers to make rapid shifts in their product lines, production processes, and organizations. This promotes changes in suppliers, partners, and mixes of skills. It has also generated a demand for a different type of worker in manufacturing. Employers seek workers who possess learning skills that allow the workers to respond to the shorter half-lives of manufacturing processes, greater cognitive skills so that they can analyze and act on data presented through computer interfaces, effective interactive skills which allow them to work in team environments, and leadership skills so that workers can promote collaboration in cross-functional and multiemployer environments (National Research Council, 1999).
Information technology has also had profound effects on service industries, resulting in improved operational performance and reduced costs. It has been used effectively to simplify and speed the management of large volumes of transactions, automate repetitive tasks, and improve information-intensive logistics activities such as purchasing, inventorying, and distribution. Increasingly, information technology is being used strategically in service industries to create greater differentiation from competitors, enter new markets, or generate entirely new businesses. These efforts include improved information management to customize services, create new or improved products such as online or automated services, and aggregate complementary services for turnkey or “one-stop” shopping (National Research Council, 1994).
Information technology has created an unprecedented ability to uncouple, redesign, and reconfigure service activities. It allows more critical evaluation of each step in a process, each process, the relationships between processes, and the roles and functions of all parties. It has provided business the ability to initiate, eliminate, change, or transfer many service activities, resulting in work restructuring and job redefinition. As a consequence, work in the service industry has both greater routinization and greater standardization, as well as increased autonomy and cognitive (intellectual) complexity. For example, call centers in insurance, banking, and telemarketing have routinized work, whereas mass-customized, short-cycle-time products have increased the knowledge requirements for certain service workers (National Research Council, 1999). Other information technology-related changes in services have involved office

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automation, flatter organizations (that is, with fewer layers of supervision and management) as a result of information dispersion and collaborative computing, mergers to leverage benefits from technological investments, and outsourcing of information management services. These have contributed to temporary job displacements for many workers, permanent job loss for some workers, and expanded skills requirements for most workers (U.S. Department of Labor, 1999a).
Distributed Work Arrangements
Technology-driven compression of space and time has caused major shifts in concepts of workplace, work space, work hours, and the boundary between work and home. Improved telecommunications, computer connectivity, and computer networks allow work to be done remotely (i.e., at home, on the road, or in client environments) and relatively more independently of the time of day. Although no standard, comprehensive data system that counts workers in nontraditional work environments exists, work at home and on the road (mobile work) is increasing and involves millions of U.S. workers. The Bureau of Labor Statistics reports, for example, that the number of people who work at home for some portion of the workday was in excess of 21 million in 1997 (Bureau of Labor Statistics, 1998d). The number of portable personal computers that have been sold indirectly reflects the enhanced mobile capability of work. Portable personal computer shipments grew from approximately 1.3 million in 1991 to 6.4 million in 1998 (Integrated Data Corporation, 1998). These changes in the location of the workplace create uncertainty regarding potential safety and health hazards, responsibility for their assessment and remediation, the validity of occupational injury and illness surveillance data systems that assume a single employer facility, and traditional notions of “exposure” that are based partly on assumptions of people fixed in space and time.
Changes in information technology hardware and software have altered the tools that people use and have contributed to changes in the physical space in which they work. Fixed computer workstations, mobile computers, other electronic interface devices (e.g., personal digital assistants), and software pose cognitive, biomechanical, human factors, and work organization challenges for comfort, well-being, and productivity. Poor workstation arrangements or setups, excessive work flows and pace, and other factors have been linked to the increased incidence of work-related musculoskeletal disorders (Bernard, 1997). The miniaturization of hardware and the evolution of distributed computing have supported changes in workspaces. Open-landscape designs are replacing enclosed offices, spacesharing among mobile workers and telecommuters is in-

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creasing, and more work is being done in client environments, at home, and in travel accommodations. Advances in information technology have also created the potential for time spent working to increase (e.g., at home), for the boundary between home life and work life to blur, and for worker performance to be measured electronically or monitored. A survey by the American Management Association (1999) found that 67 percent of major U.S. firms engage in some form of electronic oversight of employee activity. Conversely, by making work portable, information technology has also provided the opportunity for some workers to achieve a more satisfactory balance between home life and work time.
Caudron (1992) reported that from 1988 to 1992, the number of telecommuters in the United States rose from 3 million to more than 6 million people. Many but not all of these people are working in their homes. These distributed or networked employment relationships are exemplified by other situations, such as engineers who work on assignment as part of a client team, professionals who are members of advisory boards or consortia as representatives of their employers, and clerical workers who work for a number of client organizations over a year. Even within more traditional work sites, individuals are increasingly moving from one workstation to another. The growth in the number of contingent workers and other networked employees makes work environments more fluid and makes the work being performed more fluid.
Hours and Pace of Work
Since 1992, when Juliet Schor published her book entitled The Over-worked American, it has generally been accepted that people are working longer hours. However, this conclusion has met with debate, at least in the academic community (U.S. Department of Labor, 1999b). Citing the Current Population Surveys of the Bureau of Labor Statistics, the Report on the American Workforce (U.S. Department of Labor, 1999b) found the average number of hours worked per week to be relatively stable from 1960 to 1998, varying between 38 and 40 hours per week. However, there were some differences depending on certain subpopulations. For example, with the increased participation of women in the workforce, it is not surprising to find that there has been a small upward trend in the average number of hours worked per week. Although the average number of hours worked per week has been relatively constant for men, there was a small increase in the proportion of men working more than 40 hours per week. Lastly, the number of couples in which both individuals are working long hours has increased (U.S. Department of Labor, 1999a).
Data on shift work collected in a supplement to the May 1997 Current Population Survey (Bureau of Labor Statistics, 1998f) revealed that about

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25 million full-time wage and salary workers had flexible work schedules that allowed them to vary the time they started and ended work. That constituted 27.6 percent of workers, up sharply from the 1991 figure of 15.1 percent. Flexible schedules were more likely to be reported by men, parents, sales workers, executives, supervisors, and managers and by workers in service-producing rather than goods-producing industries. The same report (Bureau of Labor Statistics, 1998f) revealed that 15.2 million persons (16.8 percent of all full-time wage and salary workers) normally worked a shift other than one on a regular daytime schedule. Alternate schedules included evening shifts (4.6 percent), night shifts (3.5 percent), rotating shifts (2.9 percent), and employer-arranged irregular schedules (3.9 percent). Such schedules have long been known to be associated with increased stress and disease prevalence and may be associated with an increased frequency or severity of workplace injury as well (Office of Technology Assessment, 1991). The rapid development of e-commerce in the late 1990s and the resulting need for 24-hour responsiveness may increase the number of shift workers, but the 1997 prevalence is only slightly higher than that in 1985 (15.9 percent) and is actually lower than that in 1991 (17.8 percent).
Another time-related aspect of work is the pace of work. With the introduction of computer-aided technology, there has been an increase in the speed with which tasks are completed (Shaiken, 1985). Many of the changes in work procedures, in addition to computer-aided technology, are specifically designed to increase the speed with which organizations and individuals can respond to the demands of production (Wall and Jackson, 1995). This has essentially increased the intensity of the work pace for many employees. Such intensification of work has resulted in increased reports of stress and anxiety (Zikiye and Zikiye, 1992).
Diverse Cultures
Much of the knowledge base concerning the effects of work on employees’ safety and health has been based on white, American-born, male workers. As pointed out in Chapter 3, the workforce is becoming much more diverse. This diversity may be within groups working side by side on the shop floor, in professional and technical offices, and in the boardroom. There is some evidence that there are gender and cultural differences in people’s responses to technology. For example, Hackett and colleagues (1991) reported that women had more negative expectations than men about changes in their working conditions with the introduction of technology even after controlling for education, seniority, age, and other relevant characteristics of the job. There also may be intercultural differences in reactions to technology (Coovert, 1995). Immigrant workers, col-

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laborative work across national boundaries using Internet technology, and international alliances and mergers are all contributing to work in multicultural environments. This work environment requires accommodations and adjustments to meet a heterogeneous array of individual and group needs to successfully exploit ideas and innovations.
Implications of Changes in Work Design for Training of Occupational Safety and Health Personnel
Technology, distributed work arrangements, increased hours and pace of work, and increased diversity in the work environment create special challenges for occupational safety and health personnel. First, although application of automated production methods to dangerous and repetitive tasks has reduced some traditional workplace hazards, new hazards may emerge related to a specific technology (e.g., emissions or cognitive demands) or the manner in which it is introduced or deployed. Second, distributed work arrangements create a broad array of largely unregulated work environments outside the normal practice of occupational safety and health personnel. Third, enhanced workforce diversity challenges homogenized (i.e., “one size fits all”) communications. Understanding a workforce’s diversity will be key to developing training programs and implementing interventions that address diversity-related beliefs, customs, or practices that affect health or safety. Last, the emergence of cognitive load, the increased work pace, and the increased work hours create an urgent need for occupational safety and health personnel to be as familiar with the psychosocial aspects of work as they are with the physical, chemical, and biological aspects.
ORGANIZATIONAL DESIGN
The changing nature of work is not occurring in a vacuum. Many of these changes are results of organizations’ attempts to be more productive and competitive in a global market. This has prompted changes in organizational structures and management systems.
Self-Managed Work Teams
Manufacturing organizations started experimenting with self-managed work teams in the 1960s. By the 1990s, 26 percent of organizations surveyed by Wellins and colleagues (as cited in Wellins et al., 1991) reported using teams, but 59 percent of the organizations that reported using teams indicated that less than 10 percent of their employees were structured in teams. Despite this, the executives in that study expected

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that more than half of their employees would be working in self-managed teams by the mid-1990s. One finding that is particularly relevant to the training of occupational safety and health professionals is that in that study 69 percent of the organizations that used the team concept had placed the responsibility for safety with self-managed teams.
More than 70 percent of the organizations that participated in the study of Wellins and colleagues were in manufacturing; however, Wellins and colleagues estimated that teams were being introduced widely in all sectors of the economy. Mohrman and Cohen (1995) indicated that project teams were being used extensively in many industries, including “almost all companies that have a new product development process” (p. 371). Proehl (1996) refers to a 1992 Training magazine article that reported that 80 percent of U.S. organizations with 100 or more employees used teams and that in the largest organizations, those with 10,000 or more employees, the figure was closer to 90 percent. Coupling the notion of a matrix organization that integrates lateral communication channels with the hierarchical communications channels of more traditional organizational structures with project teams has resulted in the growth of cross-functional teams.
“Quality” Management Systems
The search by organizations to be more competitive has resulted in several new approaches to managing business processes such as just-in-time (JIT) inventory control, total quality management (TQM), and advanced manufacturing techniques (AMT). Although it is not known how many organizations are using one or more of these approaches, a survey found that almost 70 percent of the manufacturing companies in the United Kingdom were using JIT inventory control techniques as of 1991 and that most of these companies had implemented the technique since 1988 (Oliver and Wilkinson, 1992). Similar patterns of widespread use and recent shifts to these approaches are seen for TQM and AMT.
All three of these approaches are meant to enable organizations to provide a more rapid and better quality response to the demands of production. Furthermore, these processes increase the cognitive demands on employees, the responsibilities of employees, and the interdependence among all employees in the plant. As Wall and Jackson (1995) point out, these changing demands on employees can result in job-related strain. Joyce (1986) also found that changing to a matrix organization increased the level of role ambiguity, a risk factor for job stress. The experience of job stress and strain has been linked to negative effects on people’s physical health (e.g., hypertension and cardiovascular disease, [Schnall et al., 1998]), as well as mental health (e.g., depression and anxiety [Quick et al.,

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1992]). However, these approaches are espoused to empower employees and increase their job control. If this is the case, then there should not be an increase in job stress and workers’ mental health would be improved (Karasek and Theorell, 1990). Little research has directly assessed the effects of these approaches to organizational systems on employees’ health. Landsbergis and colleagues (1999), in their review of the limited research, found little support for the health-enhancing increase in empowerment and suggested that the work intensification that appears to be frequent in these systems may actually have a negative effect on the physical and mental well-beings of workers.
Nonstandard Employment Agreements
Nonstandard work arrangements include regular part-time employment, self-employment, temporary help agency work, independent contracting, and on-call work. These work arrangements antedate regular full-time employment in the United States (Jacoby, 1985) and in 1995 were estimated to account for 2.2 to 4.9 percent of total U.S. employment (Bureau of Labor Statistics, 1995). The largest numbers of nonstandard workers perform part-time work and are self-employed, but temporary help agency work has exhibited the greatest rate of growth during the last decade (see Figure 4-2 in Chapter 4). Although nonstandard work arrangements account for a small proportion of overall employment in the United States, the absolute number of workers is large and the proportion of companies that use these forms of labor has increased (Fierman, 1994; Cooper, 1995; Filipczak et al., 1995). Firms use contingent workers for a variety of reasons, including flexibility to manage variations in demand, acquiring specific expertise, filling in for absent employees, and controlling head counts or other expenses because of downsizing or competitive pressures (Rousseau and Wade-Benzoni, 1995; Human Resources Institute, 1996).
Nonstandard work arrangements create a work context with special challenges. Temporary help agency workers and independent contractors work in client environments and shift their work environments at greater frequencies than noncontingent workers (National Research Council, 1999). Control over these environments often resides outside the individual or his or her employer, and changes to the work environment may involve financial, legal, and other complexities not present in fixed, single employer premises. Occupational safety and health training is particularly important in this work context, but the person or organizational unit responsible for providing it may not be clear and contingent workers may be at risk for not receiving it in a timely fashion or in adequate amounts. For example, Kochan and colleagues (1992) reported that one-third to

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one-half of contract workers in the petrochemical industry were excluded from plant safety training programs. Access to health care may be an issue with contingent workers since they tend to have fewer or no health benefits and tend to receive lower wages than full-time workers (Barker, 1995). Growth in the numbers of contingent workers will challenge OSH personnel to rethink notions of exposure, surveillance, and intervention strategies, given the fluidity of the work environment. In addition, understanding legal considerations in multiemployer work environments will be important for occupational health professionals in implementing work site training and providing appropriate recommendations for workplace modification.
Downsizing
Since the 1980s the effects of increased international competition and globalization plus the impacts of technology have prompted organizations to consider downsizing, restructuring, and reengineering as business strategies rather than simply responses to organizational decline (Burke and Nelson, 1998; Martin and Freeman, 1998). Palmer and colleagues (1997) suggested that in the United States the reason for downsizing had moved away from general economic conditions to better staff utilization, outsourcing, plant closure, mergers, automation, and the use of new technology.
Cascio (1993) reported that between 1987 and 1991 more than 85 percent of the Fortune 1000 firms downsized their white-collar employees. These events affected more than 5 million people. According to a Conference Board survey of firms with more than 10,000 employees, 64 percent of the firms that reported that they had downsized experienced a decrease in morale among survivors, 46 percent experienced an increase in retiree health costs, and 30 percent experienced an increase in overtime (Fair, 1998). Furthermore, Pearlstein (1994) reported that two-thirds of the organizations that downsized did so again within a year. Therefore, many have concluded that downsizing, rightsizing, restructuring, or reengineering will continue.
The health and safety effects of downsizing are multiple. Victims of downsizing, those who lose their jobs, frequently experience negative effects on their general physical and psychological well-being (Kozlowski et al., 1993). Fortunately, many of these negative effects of unemployment appear to abate once an individual regains employment. It has also been documented that the survivors of downsizing experience stress and stress-related illnesses such as high blood pressure, dizziness, and stomach upset (Burke and Nelson, 1998). A recent study conducted by de Vries and Balasz (1997) found that several of the individuals they interviewed and

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who were responsible for implementing downsizing efforts exhibited depressive symptoms themselves, much the same as has been observed among victims and survivors. These results are consistent with a 1996 American Management Association Survey that found that job elimination was associated with increased disability claims. The increase in claims was greatest for categories reflective of stress (e.g., mental or psychiatric problems and substance abuse as well as hypertension and cardiovascular disease).
Implications of Organizational Design for Occupational Safety and Health Personnel
Changes in organizational structure and systems can affect employees’ well-being. These effects may be the result of job insecurity, lack of training, or stress and other psychological factors. Occupational safety and health personnel need to be aware of organizational and work design constructs and how they may be affecting employees’ health and safety. In addition, occupational safety and health personnel themselves are not immune to job elimination or being assigned to self-managed work teams. Therefore, they need to be skilled in working within multidisciplinary teams and have a core competency in business process, finance, planning, and management.
WORK-LIFE BALANCE
Social, economic, and demographic changes in the United States have increased the difficulty and complexity of balancing work demands or aspirations and home life. The aging population and increased life expectancy have contributed to the prominence of caregiving among employed persons. The U.S. Department of Labor has reported that two of three caregivers, involving 5.6 million households, were employed in 1996 (U.S. Department of Labor, 1999a). Furthermore, it is estimated that elder care will involve 42 percent of all workers by 2002 (Galinsky and Bond, 1998). Parenting is challenged by the economic necessity for dual-income households (the proportion of households in which both members of the couple work rose from 39 to 69 percent between 1970 and 1998) (U.S. Department of Labor, 1999a). Time demands for women have been exacerbated by the rise in the number of single-parent families since 1970 (11 to 27 percent), the significant increase in the proportion of mothers in the workforce (47 percent in 1975 versus 72 percent in 1998) (U.S. Department of Labor, 1999a), and the rise in the number of women holding multiple jobs (Amirault, 1997; Stinson, 1997).
Progressive employers and those in competition for particular skills

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Safe Work in the 21st Century: Education and Training Needs for the Next Decade’s Occupational Safety and Health Personnel
have responded to these work-life issues with an array of programs, resources, and accommodations. These include, for example, elder and child care initiatives, flexible work schedules, job sharing, work-at-home arrangements, on-site or telephonic concierge services, and time and stress management training. Most U.S. workers, however, do not have access to such programming or work benefits. The 1993 Family Medical Leave Act’s right to job-protected time off from work may be the principal source of temporary accommodation for many workers. However, it is unpaid leave and pertains only to serious medical conditions that affect the employee, a spouse, a dependent, or a parent and to care for a child after birth or placement for adoption or foster care.
IMPLICATIONS FOR OCCUPATIONAL SAFETY AND HEALTH EDUCATION AND TRAINING
The changes occurring in the structure of organizations and the context of work are creating new challenges for workers and worker wellbeing, particularly psychological well-being. Organizations are becoming smaller and flatter and are redefining the content of work and the nature of the employment relationship. They are pressured to compete for talent, innovate, provide exceptional service quality, and bring products and services to market fast at competitive prices. The implications of these business developments for workers include demand for new skills and continuous learning, expanded job scope, accelerated work pace, changing workplaces, uncertainty in employment relationships, heightened interactivity in job performance, and greater interface with information and communications technologies.
Work stress and its effect on health are major consequences of the changing work environment and the organization of work. Occupational health professionals must be competent in recognizing psychological conditions related to stress and in knowing the appropriate interventions and when to use relevant expert resources. They must also be familiar with concepts that relate to the structure and context of work and organizations to recognize and account for the influences that work and organizational context have on workplace injury, illness, or other health issues. These skills are essential to respond to various manifestations of cognitive overload or other work or organizational sources of distress in the workplace. The need for competency in this area is particularly keen when traditional risk factors fail to explain the occurrence or distribution of cases or events. It has been demonstrated, for example, that work organization factors are important in the epidemiology of work-related musculoskeletal disorders (Moon and Sauter, 1996; Bernard, 1997). Core curricula and training for OSH health professionals need to address these important competencies.

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